急诊

头侧位对麻醉诱导后成年人的面罩通气效率的影响

作者:姜辉,曹广慧 来源:急诊界 日期:2017-07-17
导读

         在麻醉窒息的患者中,头侧位45 °较头正位明显增加面罩通气量。遇到气道阻塞时,头位旋转可以作为提高面罩通气量的一种有效的方法。

        Theeffectofheadrotationonefficiencyof face maskventilation in anaesthetised apnoeic adults: A randomised,crossoverstudy.

        头侧位对麻醉诱导后成年人的面罩通气效率的影响:一项随机交叉研究

        BACKGROUND 背景

        Upper airway obstruction occurs commonly after induction of general anaesthesia. It is the major cause of difficult maskventilation.

        上呼吸道阻塞通常在全身麻醉诱导后发生,是面罩通气困难的主要原因。

        OBJECTIVES 目的

        The aim of this study was to determine whetherheadrotationimproves theefficiencyof maskventilationof anaesthetised apnoeic adults.

        本研究的目的是确定头侧位是否能提高麻醉诱导后存在窒息的成年人的面罩通气效率。

        INTERVENTIONS 干预

        Once apnoeic after induction of general anaesthesia, face maskventilationbegan with pressure controlledventilation, at a peak inspiratory pressure of 15 cmH2O. Each patient was ventilated for three 1-min intervals with theheadposition alternated every minute: group A, maskventilationwas performed with a neutralheadposition for 1 min, followed by an axialheadposition rotated 45° to the right for 1 min and then returned to the neutral position for another 1 min. In group B, the sequence ofheadpositioning was rotated → neutral → rotated.

        一旦全身麻醉诱导后出现窒息,即选择压力控制通气模式、吸气峰压15 cmH2O进行面罩通气。每个患者面罩通气3分钟,其中每隔1分钟进行头位变换。A组:头正位通气1分钟,接下来头右侧旋转45°进行通气1分钟,然后转至头正位通气1分钟。B组:通气时头位的顺序为:侧位-正位-侧位。

        RESULTS 结果

        Two patients were excluded due to protocol violation; thus, data from 38 patients were analysed. The mean expiratory tidal volume was significantly higher in the rotatedheadposition than in the neutral position (612.6 vs. 544.0 ml: difference [95% confidence interval], 68.6 [46.8 to 90.4] ml, P < 0.0001).

        两位患者因违反计划书被排除,因此,我们针对38例患者的资料进行分析。头侧位较头正位时平均呼气潮气量明显增高(612.6 vs. 544.0ml,差异[95%可信区间],68.6 [46.8 至 90.4] ml,P < 0.0001)。

        CONCLUSION 结论

        Head rotation of 45° in anaesthetised apnoeic adults significantly increases the efficiency of mask ventilation compared with the neutral head position.Headrotationis an effective alternative to improve maskventilationif airway obstruction is encountered.

        在麻醉窒息的患者中,头侧位45 °较头正位明显增加面罩通气量。遇到气道阻塞时,头位旋转可以作为提高面罩通气量的一种有效的方法。

        审校 曹广慧

分享:

评论

我要跟帖
发表
回复 小鸭梨
发表

copyright©医学论坛网 版权所有,未经许可不得复制、转载或镜像 京ICP证120392号 京公网安备11010502031486号

京卫网审[2013]第0193号

互联网药品信息服务资格证书:(京)-经营性-2012-0005

//站内统计 //百度统计 //站长统计
*我要反馈: 姓    名: 邮    箱: